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Treatment of periodontal disease

Periodontal disease can be prevented and controlled if a risk-based approach is used to identify the disease early, and if your risk factors can be modified.

Before we start any treatment for you we will have used PreVisor: specialised computer software to help us find out exactly what factors are involved in the disease in your mouth. It is vital to the success of any treatment that you understand what your role is in controlling your periodontal disease – unfortunately, we’re not responsible for the existence of your risk factors, and our role can only ever be to make you aware of them, and (where possible) reduce their impact by giving advice, guidance and encouragement.

For the effective clinical treatment of periodontal disease you’ll need:

1. Consistently excellent oral hygiene,

2. The thorough cleaning of the affected root surfaces to remove infected and toxin containing material, and

3. A reduction in specific types of bacteria whose presence is known to be linked with periodontal disease.

This is termed ‘non-surgical periodontal treatment’ .

Different ways of providing treatment are possible, but one of the most common is called quadrant root surface debridement (we call it RSD). In this treatment your hygienist will treat a quarter of your teeth at each visit and will use a combination of ultrasonic and hand instruments to thoroughly clean the surface of the tooth roots. This is often carried out with local anaesthesia.

Another common technique is called full mouth disinfection where systemic antibiotics (in tablet form) are given and full mouth RSD occurs over one or two longer visits.

Once the initial treatment to stabilise your gum health has happened it’s vital that an individually tailored program of longer-term care and maintenance of your gum health is followed, to avoid a recurrence of periodontal disease.

Non-surgical periodontal treatment does have its limitations, however, and when it does not achieve periodontal health,  periodontal surgery may be required to restore some of the damage caused by periodontal diseases and to give you a better chance to clean the area in the future.

Periodontal Pocket Reduction Procedures

Some cases of periodontal disease cannot be adequately treated unless a surgical procedure is carried out.

Often this will involve the gum being numbed using dental anaesthetic and then a small gum flap being created. This is folded back to expose the area of tooth and bone where the periodontal disease has caused the local problem. The root can then be cleansed directly and on occasion, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone. The gum position can also be modified when it is sutured back to aid in the area being kept clean in the future.

Reducing ‘pocket’ depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile.

Eliminating bacteria alone may not be sufficient to prevent the disease recurring. Deeper pockets are more difficult for you and the hygienist to clean, so it’s important for you to reduce them. Reduced pockets and a combination of daily oral cleaning and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.